Kentucky’s state drug court program has introduced new rules to allow opioid addicts to continue taking prescribed drug treatment medications, such as methadone, Suboxone and Vivitrol, rather than making them quit such drugs as a condition of the program.
Until this past March, Kentucky insisted that to participate in drug court, addicts must taper off any treatment meds they were on within six months. The only treatment options allowed were abstention, usually in a 12-step program.
But as we reported a month or so ago, the Substance Abuse and Mental Health Services Administration (SAMHSA) ruled that federal funding for drug courts will be denied if they make offenders stop taking legally prescribed medications to treat opioid addiction.
SAMHSA was pressured into the rule change by unnamed sources (some say the White House) after a news article in Huffington Post claimed to show that abstention is not an effective treatment approach to opiate addiction. In fact this is becoming a popular refrain at high levels in spite of the fact that a majority of Americans favor traditional detox and rehabilitation according to a recent national survey, and thousands of people reclaim drug free lives every year through abstention programs.
It was a fact that most drug court judges in the country have traditionally opposed giving methadone or Suboxone to addicts as treatment – what’s called Medication Assisted Treatment or MAT by its proponents. Judges tend to view such approaches as simply replacing one drug addiction with another, with little positive changes in addicts’ attitudes, behavior or desire to seriously and permanently get clean. Not only that, MAT drugs like methadone and buprenorphine are frequently diverted for illicit use.
Unwilling to change its drug court system, Kentucky was subsequently sued by two law firms on behalf of Stephanie Watson, a Johnson County nurse with an opioid addiction. Johnson, who had been arrested on burglary and drug charges, was barred from taking medications to treat her addiction even if prescribed by her doctor.
Watson’s lawyers argued that Kentucky’s refusal to allow her to take her prescriptions violated the federal Americans with Disabilities Act. They claimed Watson’s addiction was an “illness” similar to someone with diabetes who needs insulin. The court would never disallow the insulin, they said, so why should they disallow her MAT? There was no report in the media that her lawyers also argued that their client’s criminal behavior was part of her “illness.”
Before the Watson suit was settled, the ruling from SAMHSA arrived, and Kentucky’s drug courts immediately changed the rulings about MAT. The state said that the Watson case was now “moot” because of the SAMSHA ruling. But Watson’s lawyers have not yet set it aside.
Since Kentucky’s drug court judges have long favored abstinence-only treatment, leaving it to the judge’s discretion may mean “little change on the ground,” Huffington Post reported. Although one judge is already allowing defendants to take Vivitrol, an opioid antagonist that is injected periodically to block cravings and prevent withdrawal symptoms, it’s not clear yet what the new rules will actually mean for opioid addicts entering Kentucky’s judicial system.
Kentucky is said to be “looking to expand the use of Vivitrol” and roughly two dozen drug court judges are expected to begin allowing it soon. Judges are inclined to favor Vivitrol because, unlike methadone and Suboxone, it can’t be diverted or abused and doesn’t interfere with drug tests. In the case of those drugs that are routinely diverted, Kentucky’s judges are likely to be less open to their use.
According to Huffington Post, the SAMHSA rule means judges likely will consider allowing or disallowing MAT on a case-by-case basis. And new addicts arriving in the system probably will continue being ordered to abstinence-only programs.
A lawyer for Stephanie Watson says the state’s policy change is “window dressing that won’t change how opioid addicts are actually treated.” He predicts that drug court judges will still forbid MAT and order abstinence-only programs. “Most judges are philosophically against Suboxone and methadone,” he told Huffington Post.
The lawyer added that the Watson case will go forward “because the state’s rule change doesn’t go far enough. It’s really a battle between the courts and the doctors. The doctor-patient relationship is sacrosanct. The courts should get out of the way.”
That may be a more difficult prospect than one expects. Kentucky’s judges and those in many other states have seen with their own eyes the pros and cons of treating drugs with more drugs, versus getting off drugs right now. It may seem a lot easier to a doctor to just write a prescription. But that does nothing to get at the root of addiction.
The factual success of modern medical drug detox, such as that provided here at Novus, is clearly undeniable. Abstention from the drugs or alcohol that’s been ruining one’s life is the goal, and it starts with Novus detox. Followed by long-term and effective rehabilitation, a life free from drugs is truly possible, and it starts the day you arrive at Novus.
If you or someone you care about is in trouble with drugs or alcohol, don’t hesitate to call Novus right away. We’ll answer all your questions and ensure you get started on exactly the right program to begin a life free from drugs.
Florida parents are warned: Dangerous ‘designer drugs’ are on the streets
Two synthetic “designer drugs” are killing people, or driving them to insane behavior, or both, according to reports in the media and from federal law enforcement. But instead of scaring people off because of their unpredictable and dangerous effects, the drugs are gaining in popularity among recreational drug abusers, especially teens and young adults.
The Drug Enforcement Agency (DEA), poison control centers and police forces are warning parents to be especially on the lookout for strange behavior from their kids. The effects of the newer crop of synthetic drugs are usually LSD-like, can be seriously dangerous and their side effects can last for days, perhaps longer. It’s been shown that some people can experience recurring LSD trips even years after taking the drug, and these drugs may cause the same effects.
Two notorious synthetic drugs are called “N-Bomb” and “flakka.” They’re both powerful hallucinogens that lead to extremely dangerous and violent activity. Emergency hospital admissions for synthetic drugs are rising across the country, and treatment usually involves having to manage “extreme agitation” while trying to prevent life-threatening organ damage. These drugs are, quite literally, dangerous poisons.
N-bomb has been marketed as “legal” or “natural” LSD for a few years, and it’s blamed for at least 19 deaths and possibly as many as 30, says the DEA. It was named a “Schedule 1” highly dangerous drug last November and is now illegal. N-bomb mimics the effects of LSD, but in much more erratic and unpredictable (and more dangerous) ways.
Patients admitted to emergency wards for N-bomb poisoning “require heavy sedation to calm aggression and violence as well as external cooling measures to treat hyperthermia, or overheating of the body,” according to a report in Medical Daily.
N-Bomb, is a relatively new synthetic drug from the “NBOMe” class of drugs, from whence it got its street name. NBOMes were originally developed for psychiatric drug purposes to map serotonin receptors in the brain. Today they’re one of the most frequently abused designer psychoactive substances. N-Bomb is sold as blotter paper, powder or liquid that can be ingested, snorted, or inserted rectally or vaginally, says the DEA.
Flakka is all over South Florida and is spreading like wildfire
The other drug, called flakka, is so new it hasn’t been assigned to a drug schedule. It can’t be seized as an illegal substance yet, and sellers can’t be busted for drug dealing. Flakka is made from the same type of chemicals that are used to make “bath salts,” a notoriously dangerous hallucinogenic with potentially fatal side effects.
Drug cops say flakka looks a little like crack cocaine or meth and has a unique “sweaty” odor. It is actually a form of crystal meth, usually made in overseas labs and sold over the Internet. Flakka can be swallowed, snorted, injected, smoked and easily concealed in electronic cigarettes or a vaporizer. It’s being sold on the streets of South Florida and spreading northwards. It’s in Texas and Ohio too, and cops say it’s only a matter of time before it spreads across the country.
A report in the Miami Herald, quoting from a police report last week, says a Miami man high on flakka proclaimed himself Thor, the Norse God of War, attacked a police officer and attempted to have sexual relations with a tree. The man was first seen running naked through a Brevard County community. The man was acting completely crazy and at first could not be subdued. When an officer tried to use a Taser, the guy pulled the electric probes out of his body and just punched the officer and tried to stab him with the cop’s badge. It took enormous effort to subdue the crazed victim of flakka psychosis.
Medical Daily reports that a man ran out of his Miami house last month after smoking some flakka, stripped his clothes off and screamed violently while police chased him. It took five officers to bring the man down. Police said he exhibited the same kind of super-strength that users of crystal meth often have. He was suffering from the hallucinations and paranoid delusions so often seen in people high on flakka.
CBS news reported recently that a man stoned on flakka was arrested for trying to break down a police station door, another man high on flakka was found naked and armed with a gun on a rooftop, and a third man, trying to climb a fence, slipped and impaled himself with a foot-long spike. This is a dangerous and terrible drug.
Jim Hall, an epidemiologist at the Center for Applied Research on Substance Use and Health Disparities at Nova Southeastern University, describes flakka as creating a “bizarre high” which will probably “sweep the nation if it isn’t stopped.”
“We’re starting to see a rash of cases of a syndrome referred to as ‘excited delirium,’” Hall told CBS News recently. “This is where the body goes into hyperthermia, generally a temperature of 105 degrees. The individual becomes psychotic. They often rip off their clothes and run out into the street violently and have an adrenaline-like strength, and police are called and it takes four or five officers to restrain them. Then, once they are restrained, if they don’t receive immediate medical attention they can die.”
Similar effects are caused by another new drug in Florida and elsewhere called butane hash oil, also known as BHO or Budder. People put it in room vaporizers and become intensely high, with unpredictable results. Budder is the active marijuana ingredient, THC, mixed with other harmful chemicals. And police say its use is increasing.
DEA says N-bomb revenues are helping finance terrorists
N-bomb, which has already caused many deaths, may be helping finance terrorists. The DEA says it’s been acting on credible reports that revenues from synthetic drugs like N-bomb are ending up in the pockets of terrorists and criminal organizations in the Middle East. A DEA crackdown has led to 200 warrants, 120 arrests and the seizure of $20 million in cash.
“[N-bomb] is a dangerous drug, it is potentially deadly, and parents, law enforcement, first responders, and physicians need to be aware of its existence and its effects,” says Dr. Donna Seger, professor of clinical medicine and medical director of the Tennessee Poison Center. “The recreational use of synthetic (designer) psychoactive substances with stimulant, euphoric, and/or hallucinogenic properties has risen dramatically in recent years.”
Seger adds that the quality control of these street drugs is nonexistent. Misjudging a dose could lead to significant toxicity, with such symptoms as hypertension, rapid or irregular heartbeat, hyperthermia, dilated pupils, agitation, aggressive behavior, delirium, hallucinations, seizures, and even renal failure or coma.
Here at Novus, we help patients overcome dependence and addiction to alcohol and drugs of all kinds. We don’t see people on synthetic designer drugs as a rule, but their capacity to create dependence and addiction has already begun to surface here and there across the country.
If you or someone you know has been experimenting with synthetic drugs like N-bomb or flakka, we strongly urge you to confront this problem right away. These are very dangerous drugs because their side effects are extremely unpredictable and are potentially lethal.
Categories: Drug Facts
A troubled Marine who overdosed and died in a VA psych ward is only one of many cases of overdose in recent years. But the VA assured the committee in March that the rampant opioid prescribing has begun to ease off and other measures are being taken.
The Veteran’s Affairs has come under the gun after a damning report by the Center for Investigative Reporting on opioid prescribing at a VA hospital in Wisconsin found a 14-fold increase in oxycodone pills prescribed.
The Center found opioid painkillers prescribed at the Tomah VA Medical Center soared from 50,000 hydrocodone pills in 2004 to 712,000 pills in 2012. There was apparently no significant increase in the number of patients – just in the number of oxycodone pills prescribed per patient.
Veterans also told a reporter that opioid use was so rampant at the hospital that the soldiers gave the place the nickname “Candy Land.”
When a 35-year-old Marine Corps veteran died of an opioid overdose while in the hospital’s psych ward last August, it was only the latest in a long string of heartbreaks for veteran’s families going back many years.
Numerous reports from the VA Inspector General (IG) over the past five years say veterans are dying from medication overdoses across the country. Whistleblowers have also alerted the IG several times about dangerous opioid and benzodiazapine prescribing practices – a particularly deadly cocktail.
Tests not being done, leaving patients at risk
Yet in spite of the deaths, whistleblower warnings and the IG’s official reports, routine drug tests to monitor narcotics uses and abuses are still not being performed in the nation’s VA hospitals or among the many thousands of outpatients receiving medications.
And according to the reports, doctors are even prescribing medications to patients they have not even seen in person. Although this is a violation of written VA policy, one would think it’s a violation of basic ethical medical practice anywhere.
And just a couple of weeks ago, a former pharmacist at the Tomah VA told the committee she was “discouraged by higher-ups” from performing drug tests, in contravention of VA guidelines.
Noelle Johnson, who was fired from that facility and now is employed as a VA pain management specialist in Des Moines, said pharmacists at Tomah were discouraged from testing patients for drug use for fear of what “prescribing physicians might learn.”
Johnson said she was told that if the tests were negative, it could indicate the patient wasn’t taking their meds and were instead maybe selling them. And if the tests were strongly positive, it could “suggest overuse or abuse” and the VA could be held liable “when something unfortunate happened.”
“I believe that this is the point of urine drug testing, to substantiate use and misuse of high-risk medications for the safety of veterans and the public,” Johnson told the committee. “What happened to the doctors’ oath of ‘First Do No Harm?’”
VA is taking steps, says spokesperson
Dr. Carolyn Clancy, the VA’s interim Under Secretary for Health, told the committee that the VA has gotten the message and is taking steps to remedy the situation. Clancy said that the best way to curtail prescription drug abuse and overdose is to avoid prescribing addictive medications like fentanyl, hydrocodone or oxycodone. She said that several VA programs are in place and already working to reduce the number of prescriptions and subsequent “accidental deaths.”
“Chronic pain management is challenging for veterans and clinicians,” Clancy told the Committee. “Opioids are an effective treatment but their use requires constant vigilance to minimize risk and adverse effects.”
Clancy said a program to educate physicians on the VA’s narcotics prescription guidelines was introduced in three areas in 2013 and has been adopted by about a third of the VA’s health regions. It’s already bringing about reductions in the number of prescriptions, and also beefing up appropriate testing and tracking of patients, she said, and the VA will expand the program to include all its medical centers.
Another program, Clancy said, is called the Opioid Safety Initiative, also started in 2013, and is also helping reduce the numbers of opiate prescriptions. Since 2012, the number of patients receiving opioids has declined by 13 percent, she said, and those using opioids and benzodiazepines together — a cocktail that can have fatal consequences if taken incorrectly — has dropped by 24 percent.
Clancy also told the Veteran’s Affairs Committee about VA’s Overdose Education and Naloxone Distribution program (OEND) which provides emergency kits containing the opioid overdose antidote drug naloxone to veterans on high doses of opiates or who use multiple medications to manage pain.
Naloxone program saving lives
Since its introduction last May, she said, more than 2,400 kits have been provided to such veterans, their families or friends. And at least 41 veterans have been rescued from overdoses since the OEND program began.
Naloxone instantly reverses the respiratory depression that kills the victims of opioid overdose. It’s administered by nasal spray or injection, and is easy enough for anyone with a few minutes of instruction to use. It’s normally carried in ambulances, is used at all ERs, and is carried by many police forces across the country, since cops are very often on the scene of overdoses even before the EMT people.
The overuse of opiates for pain management and the resulting widespread dependencies, abuses and addictions to these highly addictive medications is not just a VA problem. Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, recently called the overprescribing of opioids “a national epidemic.”
Frieden said the prescribing practices of America’s physicians is the primary source of the epidemic. But the VA’s physicians went to all the same med schools as the rest of America’s doctors. So we shouldn’t expect anything different at the VA.
The Institute of Medicine says a hundred million Americans are suffering from chronic pain on any given day. Yet medical schools devote less than two days – maybe 8 to 10 hours tops – to the treatment and management of pain, including chronic pain. There are only a few thousand actual certified pain specialists in the entire country – just a drop in the bucket.
Senator says he’s “angered and disgusted”
Ranking committee member Sen. Richard Blumenthal (D-CT) said he is “angered and disgusted” that so little appears to have been accomplished to address overprescribing since the committee’s last session on the same topic.
“I want this hearing to be different, to produce action,” Blumenthal said. “This epidemic has been with us for years and years and that’s one reason for my anger and astonishment that the VA system isn’t better than it is.”
Here at Novus, we’re also looking forward to a time when opioid prescribing in and out of the military is under control. Meanwhile we’re here 24/7 helping people who have fallen victim to prescription opioids. If you or someone you care about is suffering from the addictive effects of prescription pain meds, don’t hesitate to give us a call. We’re always here to help.
The number of babies born in Florida dependent on opioids like heroin and hydrocodone has increased more than 10-fold since 1995, says a new report from the Centers for Disease Control and Prevention (CDC). And the soaring 10-fold increase “far exceeds the three-fold increase observed nationally,” the report said.
The CDC added that only 10 percent of the mothers who used opioids during pregnancy received, or were even referred for, treatment for drug dependencies.
Babies exposed to addictive prescription or illicit drugs taken by a mother during pregnancy can suffer a wide range of physiologic and neurobehavioral side effects. The condition, called Neonatal Abstinence Syndrome (NAS), is terribly sickening and painful for newborns, and can be life threatening if not treated correctly.
CDC was helping Florida streamline patient information system
In February 2014, the Florida Department of Health asked the CDC to help assess the accuracy and validity of the state’s hospital inpatient discharge data linked to birth and infant death certificates. The state wanted to know if the information could correctly monitor NAS in the state, and if it accurately describes the characteristics of infants with NAS and their mothers.
This new CDC report only focuses on the second objective – describing maternal and infant characteristics.
The CDC studied the data for 242 confirmed cases of NAS during a 2-year period (2010–2011) identified in just three Florida hospitals. The conclusions were extrapolated to apply to the whole state.
97 percent of NAS babies had to be admitted to ICU
“Infants with NAS experienced serious medical complications with 97.1 percent being admitted to an intensive care unit,” the report states, “and had prolonged hospital stays for a mean duration of 26.1 days.”
In other words, many, if not most of those 242 newborns spent nearly a month in the hospital being weaned off the addictive drugs. And the story would be the same at any of the rest of the state’s several hundred hospitals. The cost of such treatment can reach six figures for each infant.
“The findings of this investigation underscore the important public health problem of NAS,” the CDC said, “and add to current knowledge on the characteristics of these mothers and infants.”
Partly as a result of the CDC study, as of June 2014, NAS became a mandatory reportable condition in Florida – that is, diagnosed cases must by law be reported to the Florida Department of Health.
Mothers involved in cases of NAS need intervention
As to the lack of care offered or provided to drug-using mothers, the CDC says intervention should be increased, not just for NAS mothers but for all women of child-bearing age. Such intervention is needed to:
- Increase the number and use of community resources available to drug-abusing and drug-dependent women of reproductive age
- Improve drug addiction counseling and rehabilitation referral and documentation policies, and
- Link women to these resources before or earlier in pregnancy.
Only 1 percent of mothers used heroin, 99 percent prescription drugs
Once again, more evidence of America’s appalling abuse of prescription drugs: Over 99 percent of drug-exposed mothers were using prescription drugs, not street drugs like heroin.
While the whole country is up in arms about “the heroin epidemic,” less than 1 percent of NAS mothers had used heroin during pregnancy. Here’s the whole drug-use-while-pregnant picture:
- Less than 1 percent of mothers were reported to have used heroin during pregnancy
- Approximately 82 percent of mothers were using one or more prescription opioids, such as oxycodone, morphine, hydrocodone, hydromorphone, tramadol or meperidine
- 59.9 percent were using methadone and 3.7 percent using buprenorphine – both drugs commonly used for treatment of opioid dependence
- 40.5 percent were using benzodiazepines such as Xanax, Klonopin, Lorazepam / Ativan and Valium (diazepam)
- After benzos came tobacco at 39.7 percent, marijuana at 24.4 percent and cocaine at 14.1percent
- Reasons reported for opioid use included illicit (nonmedical) at 55 percent, drug abuse treatment at 41.3 percent and chronic pain treatment at 21.5 percent
- The reason for opioid use during pregnancy was unknown for 10.3 percent of NAS mothers
- Only 10.3 percent of mothers apparently received or were referred for drug addiction rehabilitation or counseling during the infant’s birth hospitalization.
Over 99 percent of NAS was from opioids
- Nearly all infants with NAS – 99.6 percent – were exposed to opioids in utero, which definitely highlights the widespread issue of opioid use in women of childbearing age.
- Women face many barriers in accessing any type of substance abuse treatment, which might also be reflected in the finding that only 10.3 percent of mothers of infants with NAS received or were referred for drug addiction rehabilitation or counseling during their infant’s birth hospitalization, despite a high percentage of mothers with positive urine toxicology screen results.
- Because abstinent detoxification during pregnancy is dangerous to the fetus, medication assistance is recommended as the standard of care for pregnant women with opioid addiction.
- Comprehensive medication assistance coupled with correct prenatal care reduces the usual complications associated with untreated opioid use disorder.
Bottom line, even one baby born dependent on drugs is one too many. Here at Novus, we deeply care about the situation, and take care to help all our female patients of child-bearing age understand the vital need for all pregnancies to be drug-free of any addictive or other toxic substances.
If you know a woman of child-bearing age who is dependent on opioids, please help them to come off these drugs before pregnancy occurs. Have them call Novus, or contact us yourself and we will help.
Are you suffering from chronic pain and aren’t satisfied with your treatment? Are you taking prescription opioids and still not getting the relief you crave? Have you tried other types of treatment and yet you’re still suffering? Are you confused by all the different things you read or hear about treating chronic pain? Even worse, are you becoming dependent on the drugs?
Well guess what, you’re not alone. You’re one of millions of Americans just trying to get by in spite of chronic, unrelenting pain. Try as you might, there doesn’t seem to be any easy answer. And in the meantime, you’re at risk of drug dependence and even overdose.
Robert Kerns, PhD, of Yale and the Connecticut VA, says that pain is a “public health problem – or, as some say, a public health crisis – that is in need of a national strategy to transform the way we think about it.” Kerns chaired one of the expert panels that recently created a new National Pain Strategy that promises to bring fundamental changes in the way pain is treated in this country.
The evidence from the past 20 or so years proves beyond a doubt that simply throwing more prescription opioids at the problem is just not working. The situation continues to worsen rather than improve. Drug dependence, addiction and death from overdose has never been more prevalent. Yet millions of Americans are still lining up at doctors’ offices with pain that just won’t go away.
Congress calls for new ‘national pain strategy’
So many Americans suffer chronic pain at some time in their lives – and treatment of that pain has historically had such hit-and-miss results – the National Institutes of Health was asked five years ago to come up with a whole new ‘national pain strategy.’
Following a mandate by Congress in the Affordable Care Act of 2010, the National Institutes of Health (NIH) contracted with the Institute of Medicine (IOM) to make recommendations “to increase the recognition of pain as a significant public health problem in the United States.”
The IOM reported back the following year, calling for a “cultural transformation” in pain prevention, care, education, and research. It recommended development of “a comprehensive population health-level strategy” to address the issues of pain and pain treatment. What this suggests is an entirely new and revolutionary approach to pain treatment and management of chronic pain – concepts that would reach all the way down to basic training in medical schools.
The IOM’s report was passed on to the Interagency Pain Research Coordinating Committee (IPRCC), which is comprised of representation from the FDA, the NIH, the CDC, the Agency for Healthcare Research and Quality (AHRQ), the Department of Defense, and the Department of Veterans Affairs.
It would be tough to come up with a more representative group of interests in pain.
And who knew we had an ‘Interagency Pain Committee’ looking out for the interests of Americans in pain? Well, we do, and they have just published their first draft of America’s new National Pain Strategy. It really does impress with the depth and breadth of its many recommendations.
A whole new way of looking at chronic pain
The National Pain Strategy completely redefines not just the way pain is treated in the U.S., but also how pain is perceived by doctors and patients. Even more importantly, it calls for more comprehensive understanding of what pain actually is, in all its physical, mental and even social complexity.
“As articulated in the IOM report,” the new Strategy says, “this cultural transformation in our efforts to reduce the burden of pain in the United States will not be achieved without sustained and indeed expanded investment into basic and clinical research studies of the biopsychosocial mechanisms that produce and maintain chronic pain and into the development of safe and effective pain treatments.”
Biopsychosocial? The Strategy defines this big word as “a medical problem or intervention that combines biological, psychological, and social elements or aspects.” And it appears all through the report.
Chronic pain is more than just “some pain.” When pain becomes chronic, it changes many aspects of life – physically, psychologically and even socially. It affects how we deal with and interact with others, our jobs, our peers, our life.
Prescription drugs don’t get at the whole problem
We can see how pouring endless amounts of prescription narcotics at chronic pain doesn’t get at the whole problem – not by a long shot. When we’re dealing with real chronic pain, we’re dealing with a whole person, not a sore elbow or a broken toe.
Smothering a chronic pain patient in a heavy blanket of numbing, addictive and dangerous drugs is as far from a solution as you can get. In fact, it makes the problem even worse.
Bottom line, biopsychosocial pain – chronic pain – is serious business. It’s something we need to know a lot more about to understand and properly treat it.
The new National Pain Strategy contains over 70 pages of detailed analysis of the whole field of pain and pain treatment, with dozens of those pages devoted to the research required to come up with truly effective, and much safer, approaches to dealing with pain.
Here at Novus, we routinely help patients deal with drug and even alcohol problems that have been brought on and made worse by efforts to treat chronic pain. And we experience great success helping our patients get their lives back.
Hopefully, the day will come when the National Pain Strategy will have transformed the treatment of pain in America, helping end the prescription drug epidemic. But until then, Novus is here and we are waiting for your call.
The Centers for Disease Control and Prevention has asked for a big budget increase to help change the way America’s doctors write prescriptions for narcotic painkillers, to help states provide better patient care and address drug-related violence, among other goals.
Prescription medications are dangerous, says CDC director Thomas Frieden, MD, and particularly opioids. “You only have to take a few doses to become addicted, potentially for life.” And yet, Frieden says, the harms of opioid medications are still not recognized by patients – or by providers.
“This is a problem that was fundamentally created by bad prescribing practices, and it can be ameliorated greatly by improving those practices and providing additional services to patients and to physicians,” Frieden said.
The CDC director is asking the House Committee on Appropriations for nearly quadruple its annual budget allocation for the “Prescription Drug Overdose Prevention for States Program.”
For fiscal year 2015, the CDC asked for a $15.6 million increase to expand the program to several more states. But for 2016, the agency wants to take the program nationwide.
The CDC’s addiction overdose program is aimed at accomplishing three general goals that are seen as major contributors to addiction and overdose:
- Improving data quality and surveillance to monitor and respond to the epidemic .
- Strengthening state efforts by scaling up effective public health interventions.
- Supplying health care providers with the data, tools, and guidance needed to improve the safety of their patients.
- More than 60 people die every day in the United States from overdosing on prescription drugs – over 21,000 a year, eclipsing the American deaths from traffic accidents, natural disasters, disease epidemics and even war.
- PDO death rates now outnumber deaths from all illicit drugs—including heroin and cocaine—combined.
- PDO death rates quadrupled in just ten years (1999-2010), claiming more than 16,600 lives in 2010.
- In 2013, prescription opioid deaths remained essentially level with 2012, maintaining the slight decline seen the previous year but not declining any further.
- Prescription opioid abuse resulted in more than 400,000 emergency department visits in 2011, and cost health insurers an estimated $72 billion annually in medical costs.
One of the details of the program is to maximize the effectiveness of prescription drug monitoring programs (PDMPs) and zero in on at-risk communities, the CDC said. PDMPs have fast become a valuable tool in reducing “doctor shopping” for the diversion of addictive drugs to illicit personal abuse as well as drug dealing.
Recent state and county crackdown on Florida’s notorious “pill mills” has seen a significant drop in such activities. The Sunshine State had spent over a decade as the worst state in the nation for the diversion of illicit prescription drugs.
In addition to prescription drugs, the CDC does acknowledge the known problems with illicit street drugs, especially heroin. “Much more remains to be done to address opioid-related [prescription] overdose deaths and also the troubling rise in overdose deaths from illicit drugs such as heroin,” the CDC said.
If you’re a typical, modern American woman, or even any woman almost anywhere, you’ve likely been taught from birth to stifle your feelings, especially around men.
You’ve been told, and probably have come to believe, that your deeply felt feminine intuitions are suspect and your emotions are not valid and not wanted by others around you – particularly by men.
As a result, when you feel something rather deeply you hesitate to express it with all the care and emotion that propels it. And the result of a lifetime of suppressing your feelings and thinking there’s something wrong with feeling them is, in a word, unhealthy.
Julie Holland, a New York City therapist, expresses it perfectly in a recent Opinion piece in the New York Times Sunday Review. She says that “women are moody. By evolutionary design, we are hard-wired to be sensitive to our environments, empathic to our children’s needs and intuitive of our partners’ intentions. This is basic to our survival and that of our offspring.”
But our society’s cultural habits are opposed to that very natural and healthy nature. “Women’s emotionality is a sign of health, not disease; it is a source of power. But we are under constant pressure to restrain our emotional lives. We have been taught to apologize for our tears, to suppress our anger and to fear being called hysterical.”
Holland points out that the pharmaceutical industry “plays on that fear, targeting women in a barrage of advertising on daytime talk shows and in magazines.” She says that more Americans are on psychiatric medications than ever before and they’re staying on them far longer than was ever intended.
Sales of antidepressants and anti-anxiety medications have soared over the past 20 years, she adds, and they’ve recently been outpaced by Abilify, an antipsychotic drug that’s now the number one selling drug among all drugs, not just psychiatric ones.
One out of every four American women are taking some sort of psych drug, compared to one in seven men. In other words, 30 or 40 million women are consuming drugs to try to suppress what in fact are, in all but a tiny fraction of cases, natural human traits that every normal woman is born with.
The situation, Holland says, is simply insane.
Women are twice as likely as men to be diagnosed with depression or some sort of “anxiety disorder” and receive prescriptions for psych drugs. This is worse than just making the doctors and especially Big Pharma very rich, which of course is a fact.
It’s creating what Holland calls “a new normal, encouraging more women to seek chemical assistance. Whether a woman needs these drugs should be a medical decision, not a response to peer pressure and consumerism.”
Holland says the “new, medicated normal” is at odds with female biology, in which brain and body chemicals “are meant to be in flux.
“To simplify things, think of serotonin as the ‘it’s all good’ brain chemical. Too high and you don’t care much about anything; too low and everything seems like a problem to be fixed. In the days leading up to menstruation, when emotional sensitivity is heightened, women may feel less insulated, more irritable or dissatisfied,” she says. “I tell my patients that the thoughts and feelings that come up during this phase are genuine, and perhaps it’s best to re-evaluate what they put up with the rest of the month, when their hormone and neurotransmitter levels are more likely programmed to prompt them to be accommodating to others’ demands and needs.”
She says that taking psych drugs, which artificially stimulate the production of the ‘it’s all good’ serotonin, is a bad idea. “Too good is no good. More serotonin might lengthen your short fuse and quell your fears, but it also helps to numb you, physically and emotionally.”
Holland explains that psych drugs frequently leave women less interested in sex and blunt negative feelings more than they boost positive ones. She says you “won’t be skipping around with a grin, it’s just that you stay more rational and less emotional.”
This “emotional blunting” encourages women to behave in ways that are approved by men – appearing invulnerable, for example, which might help a woman move up in a male-dominated business. But it isn’t real and it isn’t normal.
Some people on psych drugs have reported less of “many other human traits: empathy, irritation, sadness, erotic dreaming, creativity, anger, expression of their feelings, mourning and worry,” Holland says. “People who don’t really need these drugs are trying to medicate a normal reaction to an unnatural set of stressors: lives without nearly enough sleep, sunshine, nutrients, movement and eye contact, which is crucial to us as social primates.”
At Novus, we encounter many patients who have used and even come to rely on anti-anxiety and antipsychotic drugs, often in combination with other addictive substances like alcohol or prescription painkillers. In our experience, patients who have detoxified from their habitual substances, and improved their health through correct diet and supplementation, routinely no longer feel the need to mask or manipulate their true feelings with substance use and abuse.
If you or someone you care for is using or abusing drugs, don’t hesitate to give us a call. We’ll answer all your questions and help you find the perfect solution to the problem.
Yes, it’s true, you read that headline correctly.
The leading source of opioids for the highest-risk users and abusers are doctors – not the pushers on America’s streets.
Researchers from the Centers for Disease Control and Prevention (CDC) say that most people who abuse prescription opioids get them friends or relatives, but “those at highest risk of overdose are as likely to get them from a doctor’s prescription.”
“Many abusers of opioid pain relievers are going directly to doctors for their drugs,” said CDC Director Tom Frieden. “Health care providers need to screen for abuse risk and prescribe judiciously by checking past records in state prescription drug monitoring programs. It’s time we stop the source and treat the troubled.”
The CDC report, published in the Journal of the American Medical Association Internal Medicine, says their research “underscores the need for prevention efforts that focus on physicians’ prescribing behaviors and patients at highest risk for overdose.”
CDC explains that a “highest-risk user” is someone who uses opioids more than 200 days a year. This level of use is way beyond what is considered safe for anyone.
Prescription narcotic painkillers are the leading cause of drug deaths in America, and probably in the world. Prescription opioids like oxycodone (OxyContin, Roxicodone, Percocet, Endocet) and hydrocodone (Vicodin, Zohydro, Hysingla, Dilaudid) and countless others are the most abused drugs on earth.
Yes, there has been a huge up-tick in heroin addiction and overdose deaths in the past few years. And that’s alarming, to be sure. The CDC found that heroin deaths nearly quadrupled from 2000 to 2013, and heroin related deaths occur in all demographic groups and regions of the country. Heroin overdose deaths soared a staggering 39.3 percent just from 2012 to 2013.
Across the U.S. in 2013, there were 44,000 drug overdose deaths. Nearly 23,000 were from prescription drugs, and 16,000 of those involved powerful prescription narcotic painkillers such as Vicodin and OxyContin. So well over half of all drug deaths were from prescription drugs, and two-thirds of those were narcotic prescription painkillers.
Every day 120 people die as a result of a drug overdose and another 6,748 are treated in emergency departments (ED) for drug mishaps. And well over half of those deaths and ER visits are caused by the misuse of prescription drugs.
Here’s the complete breakdown, straight from the CDC:
“Data have shown that the majority of all people who use opioids for nonmedical reasons (using drugs without a prescription, or using drugs just for the “high” they cause) get the drugs from friends or family for free. Prevention efforts have focused on this group, emphasizing methods such as collecting unused medications through take-back events that are aimed at providing a safe and convenient way of disposing of prescription drugs responsibly.
“But these efforts fail to target those at highest risk of overdose: people who use prescription opioids nonmedically 200 or more days a year. CDC’s new analysis shows that these highest risk users get opioids through their own prescriptions 27 percent of the time, as often as they get the drugs from friends or family for free or buy them from friends. And they are about four times more likely than the average user to buy the drugs from a dealer or other stranger.
“Researchers analyzed data for the years 2008 through 2011 from the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Survey on Drug Use and Health (NSDUH). Other major sources of opioids for frequent nonmedical users include obtaining drugs from friends or relatives for free (26 percent), buying from friends or relatives (23 percent), or buying from a drug dealer (15 percent).”
So today, when we look at the big picture, we see that prescription opioid-related mishaps and deaths continue to exceed street drugs including the much-publicized heroin “epidemic.” Yes there is an epidemic of drug addiction and death in this country, but it is the misuse of prescription drugs which dwarfs the problems caused by heroin alone.
Nearly 5 years ago, Novus reported on another study that called for basically the same actions from doctors to help save lives. Titled “Study Reveals Doctors Can Do More To Prevent Prescription Drug Abuse”, it was also published in a respected medical publication, the Journal of General Internal Medicine.
That study said that “doctors could go a long way to reducing prescription drug abuse by more closely screening and monitoring patients prescribed opioid painkillers and other addictive drugs. Researchers at Yeshiva University in New York City found that most doctors provide ‘disturbingly low monitoring rates’ for patients taking prescription drugs, such as highly addictive opioid painkillers.”
Sounds eerily familiar to the new study from the CDC, doesn’t it. Let’s hope the CDC’s new study actually gets the ball rolling.
Let’s say it one more time: The biggest problem is the inherent danger of prescription narcotics, including when legitimately prescribed by doctors. More people are in danger by popping pain pills than abusing street drugs. So doctors need to pay more attention to their patients.
Here at Novus we are in the business of helping people from all walks of life get their lives back from drugs and alcohol. Believe us, we do pay attention. And we get a tremendous boost every time a patient blooms like a blossom in spring after getting off prescription opioid painkillers.
In fact, many patients are also getting free from other prescription drugs at the same time, often benzodiazapines like Xanax. So it’s a double or even a triple win for everyone concerned.
If you or anyone you care about has a problem with prescription or street drugs, don’t wait another minute. Pick up your phone and call Novus right now. We’re specialists in helping people get their lives back. And we’re always here to help.
When a long term opiate addict now in recovery says he chose to get off drugs – all drugs – instead of going on a methadone program that could trap him for years, maybe it’s time more people paid attention to what he and thousands like him have to say.
Nicholas Colvin of Annapolis, MD, a former opiate addict, told the Maryland Capital Gazette recently, “I haven’t heard of a long-term success story for methadone. You’re still in that mind frame — you need this other substance to get your day started, illegal or not. Why would you want to live like that for years when you could be drug-free? It’s another form of control and it’s not freedom.”
Colvin said he’s been drug-free since July 6, 2012. And he says he “beat his addiction to heroin, cocaine and Percocet without methadone.”
So Colvin is living proof – one of millions around the world – who have gotten themselves free from opiate addiction without relying on a secondary addiction to methadone, in the hope that someday, somehow, you’ll manage to get off methadone.
But those tens of thousands of Americans are buying the methadone fairy tale from a lot of heavy hitters – people calling themselves addiction experts and even scientists. People like
Dr. Babak Imanoel, medical director of Adult Addiction in Maryland.
According to the Gazette, Imanoel said that methadone isn’t meant to cure addiction but treat it. He said it is the most effective because it relieves pain and gives patients structure.
“What people want to focus on,” Imanoel told the Gazette, “is ‘How long do you have to be on this?’ My answer is how long does someone with diabetes have to be on insulin?”
Well there you have it. The good doctor, a self-styled addiction “expert,” is clearly stating that once an opiate addict has been switched to methadone, that’s it for life. Because any doctor will tell you, cases of coming back from diabetes and insulin are, well, pretty much zero.
Our reply to Dr. Imanoel’s claim that methadone “relieves pain and gives patients structure.”
You want to be free of pain and get some structure back in your life?
GET OFF OPIATES!!! NOW!!!
Nicholas Colvin said from his experience, inpatient care is most effective but it isn’t accessible to most drug addicts because they usually lack insurance. Colvin went to an inpatient program in Crownsville, MD, called Hope House, that offers counseling, support and medical care. He became a certified recovery specialist after completing the program himself.
Colvin said prisoners released after completing their sentences are directed for continued treatment at Dr. Imanoel’s methadone clinic. But, Colvin added that he saw many people relapse and find their way back to jail. When questioned about this, Imanoel told the Gazette that relapses at the clinic’s methadone program are “common” but the counselors and nurses “work with the patients” to get them back on track.
Meanwhile, the methadone proponents trumpet loudly about their low relapse rates. It’s those who attempt to get off opiates without an alternative drug like methadone that do all the relapsing, they say. Maybe they should pay a visit to a real methadone clinic and take a really good look.
Just like Nicholas Colvin and countless thousands of others, people are getting their lives back every day across America without having to stay addicted for goodness knows how long to a secondary opiate like methadone.
First of all, methadone is not a “treatment.” The word “treatment” means to relieve or cure something. Repeat: Relieve or cure something.
So what is the “something” you’re trying to treat? It’s called Addiction – the need to consume a drug every day in order to survive. You’re trying to relieve or cure addiction.
So what is methadone? An opiate. What does it do? Keeps you addicted.
Now, explain how anyone can say that giving methadone to an opiate addict is a “treatment”?
It does nothing to relieve addiction, because you’re still addicted. So it certainly does nothing to cure addiction.
To actually treat the addiction, to relieve or cure addiction now, you need to get off methadone.
But you could have done that with the heroin or Vicodin or Oxycodone in the first place.
That is the message Nicholas Colvin was trying to convey at the outset of this blog.
Now comes the second, and even more horrifying aspect of methadone so-called treatment:
- It’s more difficult to get off then heroin or oxycodone or hydrocodone or any other opiate. It takes longer and it hurts more.
- As the tolerance for methadone increases, you need more every day to ward off withdrawal symptoms.
- So the longer you are on methadone, the greater the chances of raising your dosage to levels that are widely considered UNtreatable.
So much for methadone “treatment.”
The punch-line for this scary scenario is this. If an addict decides that the time has finally come to become drug free at last, getting off a high-dose methadone addiction can be a nightmare. Stepping down from a high dose, even with medical assistance, can be an invitation to failure.
Also, few drug detox centers will accept high-dose methadone addicts for treatment – real treatment, that is, getting free from addiction once and for all. You have to look far and wide to find a reliable detox clinic that knows how to deal with high dose methadone addiction. Because it is not an easy thing to do without a lot of specialized knowledge and experience.
Here at Novus, we have that knowledge and experience. We are one of the few medical detox centers in the country that accepts high-dose methadone patients. We routinely achieve great results, and our patients leave feeling better than they’ve felt in years. They’ve finally won their years-long battle for independence from daily shots of methadone. At last, they are drug free and ready to get their lives back.
If you or someone you care about is in trouble with opiate dependence or addiction, do everyone a favor. Call Novus and get the help you need right now. Don’t opt for the methadone addiction prison. Let us help get you or your loved one off drugs, right now.
Zohydro ER, the extended release hydrocodone prescription painkiller that caused a firestorm when the FDA approved it over a year ago, has finally been released in a new abuse-resistant formulation.
An extended release painkiller contains 5 or 6 times as much opioid as a single-dose pill. It’s intended to be released slowly over many hours after you take it.
But addicts want to get all that opioid in a single hit by crushing it into a powder and snorting it, or mixing it in a liquid and shooting it up with a syringe.
The new Zohydro ER is made using something called BeadTek technology, which is designed to deter abuse “without changing the release properties of hydrocodone when Zohydro ER is used as intended,” says the announcement from the pill’s maker, Zoegenix, Inc., of San Diego, CA.
The company claims that, when the new pill is crushed and mixed into a liquid or solvent, the BeadTek technology turns it into a viscous gel that’s impossible to use in a syringe.
The product label won’t include the abuse-deterrence claim until later in the year after the company finishes “Human Abuse Liability studies” of the pill’s new abuse-deterrent properties and submits the results to the FDA. These findings will affect the wording for the label.
Original FDA approval ignited a firestorm
Zohydro ER, the first pure hydrocodone extended release pill ever, with no abuse deterrence at all, was asking the FDA for approval to bring it to market.
We already knew that hydrocodone was the most abused prescription opioid in America – even mixed, as it always was with acetaminophen in drugs like Lortab, Norco and Vicodin.
Also, the country had already endured the horrors unleashed by Purdue Pharma’s OxyContin – a pure oxycodone extended release painkiller that triggered a decade of addictions, overdose deaths and ruined lives across the country.
Purdue Pharma had come out with an anti-abuse version of OxyContin back in 2012, and it was seen as making a difference. Well actually, sending most addicts on to heroin or over to the various other painkillers like hydrocodone, hydromorphone and others.
But now, here came Zohydro ER, pure hydrocodone with no built-in deterrence. It looked to everyone concerned like OxyContin all over again.
The FDA’s approval of the original Zohydro ER ignited a firestorm of adverse reaction in the media, letters to the FDA from institutions all over the country, even demands that the head of the FDA resign. Criticism came not just from the public, but also from a wide cross-section of the medical profession. The consensus was that Zohydro ER offered nothing but more danger of abuse and deaths from overdose, since there was no real need seen for more opioid painkillers.
Not only did the FDA approve Zohydro ER as-is in the face of all this criticism, it did so against the direct recommendation of its own medical, scientific and research advisory committee to disapprove the drug and keep it off the market.
DEA classifies hydrocodone as even more dangerous
Last year, not too long after the FDA approved the original Zohydro ER and after more than a decade of hemming and hawing, the Drug Enforcement Administration (DEA) finally rescheduled hydrocodone-containing meds as Schedule II drugs, up from Schedule III.
In plain English, this meant it was finally acknowledged that hydrocodone is just as dangerous as oxycodone, which has always been Schedule II.
We at Novus were pleased to report on the DEA rescheduling of hydrocodone, since we see the harm that hydrocodone has brought to so many of our patients. Hydrocodone is among the top killer drugs in America.
And believe it or not, 99 percent of all hydrocodone is consumed right here in America. The rest of the world just isn’t interested, because there are plenty of other prescription opioids to choose from. And many, if not most pain management specialists, even here in America, question the need for more.
Also, late last year, Purdue Pharma came out with its own anti-abuse hydrocodone extended release painkiller, with the company’s abuse-resistance technology built in. Called Hysingla ER, it’s abuse-deterrent technology “discourages” chewing, crushing, snorting or injecting.
Even a legitimate prescription can lead to hydrocodone dependence
Let’s not forget that there are many medical patients who take legitimate, doctor-ordered hydrocodone or other opioids for pain, who then become dependent on the drugs – abuse-resistant or not. These people need to be carefully weaned off those drugs, but some of them actually become addicted.
So here we are, in a country awash in prescription opioid painkillers (there are dozens) and countless thousands of prescription opioid painkiller addicts, and we have not one, but two new ones. And doctors often find themselves stuck between a rock and a hard place – wanting to help their patients, but at the same time wanting to avoid over-medicating with seriously addictive painkillers.
There is a movement afoot among pain specialists and researchers to find solutions for mild and moderate pain other than opioids and opiates. Some approaches are already being used, but it’s rough going when the American public is demanding opioids, and nearly all regular doctors know very little about alternatives. Perhaps this will be the subject of a future blog.
Meanwhile, here at Novus, we’re known far and wide for our medical breakthroughs in opioid detoxification, including hydrocodone. Our proprietary opioid detox protocols result in much more comfortable detox experiences for our patients, and even improves patients’ overall health. Patients often remark as they’re leaving, “I haven’t felt this good in years, even before I got into trouble with (substance abuse).”
If you or someone you care for has a problem with opioid dependence or addiction, don’t hesitate to call us. We are always here to help.